Motivational Interviewing: Conversations about Change: Several Clear Options in Planning

Once we have confirmed the goal, and any subgoals along the way, we are now ready to itemize the options or list what has been discussed in counseling sessions. The counselor may be supportive in sharing back to the client some of the options that have been named in previous sessions. In this part of the process, it is not necessary to explore any of the options in great depth, but rather to put a list together.

Like what was mentioned above, some options may have already emerged in early conversations between clinician and client. The clinician can also be helpful during this process if they know of any sound practices or approaches that may support the client in achieving their goal. Of course, the clinician would always ask the client permission to offer these practices or approaches.

Below are the tasks provided by Miller and Rollnick of the territory to cover with a client who has several ways to move forward. The second task we will explore is creating a list of possible ways for the client to reach their desired goal.

  1. Confirm the goal, and as appropriate, subgoals along the way.
  2. Itemize the options that are available or have been discussed.
  3. Elicit the client’s hunches/preferences as to the best way forward.
  4. Summarize the plan and strengthen commitment.
  5. Troubleshoot-raise any concerns you have.

If the client provides permission for the clinician to share possible approaches, the clinician can offer a menu of options to the client. This can be a list of possible ways to achieve their desired goal. This would not limit any ideas the client can add to the conversation, but instead increase the number of options that are available for consideration.

In this part of the process, the goal is to come up with options and not evaluate or critique them. This could be considered a brainstorming session and allow both the clinician and client an opportunity to share ways forward to achieve the client’s goal. By both clinician and client sharing their ideas, a collaborative foundation can be created in the therapeutic relationship.

Again, the plan is to generate a list of available options to choose from. In next month’s blog, we will continue looking at the tasks to review with the client and talk about evaluating the options. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing.

For more information about Motivational Interviewing or related services, contact Steve Bradley-Bull, LCMHC, by phone, (919) 812-9203, or by email, steve_bradley-bull@med.unc.edu

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